After breaking a promise to protect people with pre-existing conditions, a number of House Republicans voted for the American Health Care Act (AHCA) in part based on the Upton amendment. The Upton amendment added $8 billion to the AHCA in an attempt to lower premiums or out-of-pocket costs for people whose premiums are ratcheted up due to a pre-existing condition.

Discriminating against people with pre-existing conditions through higher premiums is prohibited under the Affordable Care Act (ACA). The AHCA allows states to remove this protection, and then attempts to remedy the situation by adding $8 billion through the Upton amendment.

A new analysis by the Congressional Budget Office (CBO) confirms that the AHCA, on net, would cut protections for people with pre-existing conditions. Specifically, CBO states, “less healthy people would face extremely high premiums, despite the additional funding that would be available.”

Upton’s investment is a fraction of the bill’s spending, according to CBO, on priorities such as tax breaks for insurance corporations, drug companies, and high-income people.

A comparison to other funding elements of the AHCA puts this vote-swaying provision in perspective. Upton’s investment is a fraction of the bill’s spending, according to CBO, on priorities such as tax breaks for insurance corporations, drug companies, and high-income people.

For every $1 the Upton amendment spends on people with pre-existing conditions, the bill spends:

This reflects the overall choices that House Republicans made in this bill: provide hundreds of billions in tax breaks for the wealthy and corporations at the expense of people with pre-existing conditions, tax credits for people purchasing coverage in the individual market, and people with Medicaid.

It remains to be seen whether Senate Republicans will make the same choice.

Jeanne Lambrew, PhD, is a senior fellow at The Century Foundation and an adjunct professor at the NYU Wagner Graduate School of Public Service. Her writing, research, and teaching focus on policies to improve health care access, affordability, and quality.